[email protected]: Rewriting The Rules For Medicaid Managed Care It must have been at least a week since we’ve had a major campaign “gaffe” (really, who can keep track?), so into that breach Jeb Bush bravely stumbled yesterday, seeming to dismiss the notion of spending too much on women’s health care, when he said “I’m not sure we need half a billion dollars for women’s health issues.” Naturally, Hillary Clinton was all over him, guaranteeing that there would be many stories written about it. (Paul Waldman, 8/5) In 2014, an estimated nine million people became newly insured thanks to Obamacare. There’s an oft-expressed view that getting all those people covered could actually save the health system money. The argument goes something like this: Once people have insurance, they’ll go to the doctor instead of an expensive emergency room. Or: Prevention costs far less than a serious illness down the road. … This argument for the cost savings from universal health coverage makes some intuitive sense, but it’s wrong. There’s strong evidence from a variety of sources that people who have health insurance spend more on medical care than people who don’t. (Margot Sanger-Katz, 8/5) The New York Times: No, Giving More People Health Insurance Doesn’t Save Money Health Affairs: Don’t Repeal The “Cadillac Tax” On High Cost Health Plans California Healthline: Oscar Wants To ‘Revolutionize’ Health Care. But Will It Even Survive Covered California? Hi, Oscar. That’s the clever framing that founders of the buzzed-about startup health insurer Oscar have used for their website (hioscar.com) and advertisements. And the company will soon introduce itself to Californians; Covered California also confirmed that Oscar will start selling plans in Los Angeles and Orange County. But can Oscar’s services live up to its press clippings? And is the New York-based company ready to compete in a brand-new market, more than 3,000 miles away from its home base? (Dan Diamond, 8/5) Viewpoints: Getting Insurance Doesn’t Save Money; Cadillac Tax Key To Keeping Costs Down A selection of opinions on health care from around the country. In July, Alaska Governor Bill Walker (I) announced his intention to unilaterally implement Obamacare’s Medicaid expansion. Walker’s expansion would shrink Alaska’s economy, discourage work, crowd out resources for truly needy patients and ultimately put funding for education, pensions and other critical services at risk. But Gov. Walker’s unilateral Obamacare expansion isn’t just bad policy, it’s also likely illegal. (Jonathan Ingram and Josh Archambault, 8/4) Politico: Planned Parenthood Did Nothing Wrong Republicans on Capitol Hill, and now GOP presidential candidates like Donald Trump and Jeb Bush, are jumping over each other to defund Planned Parenthood because it transfers fetal tissues to researchers at cost. But if Americans want the benefits of biotechnology—helpful surgeries, cosmetics, vaccines, Alzheimer’s treatment and pharmaceutical drugs—they and their elected representatives need to learn a few basic facts about how these social services and products are derived from human tissue research (Michelle Goodwin, 8/5) Forbes: Is Alaska Gov. Bill Walker’s Medicaid Expansion An Illegal Power Grab? The Washington Post’s Plum Line: What Jeb Bush’s ‘Gaffe’ On Women’s Health Really Tells Us The Washington Post: Why Did Health Spending Rebound? Medicaid, which turned 50 years old on July 30, 2015, has grown to become the largest single type of health care coverage in the United States, providing health insurance coverage for about 66 million low-income people who are not eligible for or cannot afford other forms of coverage. The population groups served by Medicaid have evolved over time, as has the delivery model, from fee-for-service to managed care. About 58% of all Medicaid beneficiaries, 39 million individuals in 39 states and the District of Columbia, accessed Medicaid benefits through capitated health plans in fiscal year 2011 (the most recent year with complete data). Most of the growth of Medicaid managed care is the result of a mandatory requirement in many states for specified eligibility groups to use this delivery model. (Andrew B. Bindman, 8/5) The greatest deficiency of the Affordable Care Act was its failure to address the problem of excessive health care costs. The most effective, and probably the only effective, way to reduce costs is through a fundamental change in incentives. We need a health care system in which practically everybody has a choice of health plan and an opportunity to keep the savings by choosing economically — that is, a regime of defined contributions and responsible consumer choice. Provider interests were too powerful to permit a serious cost containment component in the ACA. An outright repeal of the Cadillac Tax would not only undermine the cost containment efforts now underway, but it would be an unmistakable signal that our democracy is not capable of reining in excessive health care costs. (Alain Enthoven, 8/5) It was nice while it lasted, but it’s over and may not return for many years, if ever. The “it” is the slowdown in national health spending. From 2008 to 2013, health spending grew roughly 4 percent a year, which was less than half the 9 percent average of the three decades before the Great Recession. Because the 4 percent rate matched the economy’s overall growth, health spending stabilized at 17.4 percent of gross domestic product (GDP). There was some hope that an era of sizable increases was over. Forget it. (Robert J. Samuelson, 8/5) This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.